When It Absolutely, Positively Needs to Be There Overnight

In the late 1970’s, FedEx, a multi-national conglomerate company which specialized in global delivery services launched an advertising campaign that became their mission statement and philosophy. “When it absolutely, positively has to be there overnight” appeared in their print ads, their television and radio commercials, and on flyers, and signage in their ubiquitous storefront counters. The statement encapsulated the messaging from FedEx: if you can’t afford a delay, use us. FedEx would describe the tagline as “more than a slogan—it was a promise that demanded trust”. FedEx grew meteorically through the late 1970’s and into the 1980’s. Their brand remains today and they are synonymous with not only global delivery, but e-commerce business solutions.

DME organizations can relate to items that “absolutely, positively need to be there overnight” (or within an hour, as the case may be). When you are in the business of providing life supportive equipment and services, you don’t lock the store up at 5pm and go home and forget about your customers. And even delivery by drop shipping and mail order is more sensitive and critical than the average Amazon delivery. While we’ve grown to expect Amazon to deliver toothpaste and socks immediately, the immediate need for DMEPOS supplies and equipment remains and has always been a priority.

DME organizations sometimes ask about what services they are required to provide 24/7, and which services can wait till the next business day.

Accreditation standards as well as licensure laws and regulations allow some latitude with regards to your scope of service and whether you want to answer the phones and provide services around the clock. However, there are some deal breakers—equipment and services that MUST be provided, serviced, and maintained around the clock, 24/7. These include life supportive, life sustaining equipment. Grab bars, most bent metal DME, walkers, TENS units, diabetic supplies and glucometers, diabetic shoes, ostomy, and braces all fall into the NON-life sustaining category. You aren’t required to take calls and set up this type of DMEPOS around the clock. Ventilators, oxygen, most respiratory therapy equipment and supplies, infusion pumps, and enteral food pumps ARE life sustaining and must be serviced.

Those “life sustaining” and “non-life sustaining” buckets are pretty easy to use to categorize your services, equipment, and supplies. Where the lines start to blur are issues such as:

• What about new patients being discharged from the hospital to home after hours? It’s pretty clear that your organization needs to be available to service existing patient/customers with equipment such as ventilators or oxygen. It may be more of a business decision whether you want to take on NEW patient/customers with ventilators or oxygen after hours. Telling a referral source to call back tomorrow might be allowed by law and regulation, but it isn’t necessarily good business and might cost you a customer.
• Emergency service: What does that even mean? If an oxygen patient calls and says their machine isn’t working and they’re using their back up cylinder, which is going to last three or four hours, it is apparent that someone needs to go out and service, repair, or replace the equipment. But if they call and want a new humidifier bottle, it can most likely wait until the next business day.
• Triaging calls: If you offer full line DMEPOS and are on call at night, an oxygen call might require an emergency home visit. But if a patient/customer calls because they want some disposable supplies such as wound care or diabetic supplies, your organization can certainly ask the patient/customer to wait until the next day for delivery. It’s fairly common for DME organizations to instruct their customers that respiratory equipment and services can expect 24/7 on call availability, but basic DME can wait to transact business and receive deliveries and services during regulator business hours.

To avoid the appearance of shoddy customer service, organizations should be very clear about their scope of service and what services, equipment, and supplies can be delivered, set up, or repaired after hours and over the weekend. If your business is open half a day on Saturdays, let the customers know. If all deliveries with the exception of emergency issues that pop up are done Monday through Friday during business hours, let the customers know. Spell out what is available after hours at the time of set up and in your paperwork and on brochures and marketing materials.

Be careful to make sure you comply with accreditation standards, law and regulation, and payer requirements. Many payer sources do not allow extra charges to the customer to cover after hours deliveries or call outs.

Finally, try to educate referral sources –especially the local hospitals and doctor’s offices—concerning your hours of operations and what you are willing to do after hours and over the weekend. Be consistent in applying your own practices and procedures. Marketing efforts should reinforce your practices with regards to after-hours set ups and service. I remember starting a program many years ago with a DME I worked for where we told a local hospital we’d set up medication compressors 24/7 at a patient’s home or even in the hospital ER. Now, reimbursement for medication compressors was a lot higher than it is today and we had an affiliated pharmacy that was able to sell unit dose medications along with the compressor. The program was quite successful and we earned an excellent reputation as the company that goes above and beyond the required. However, years later, the DME had to navigate a public relations dilemma when they discontinued the program. In short, be careful and clear about what you promise.

DME organizations are used to providing equipment and services quickly and efficiently at both convenient and inconvenient times. Think through how you structure your organization’s policies, procedures, and practices with regard to providing speedy, 24/7 customer service and delivery options. And once the program is up and running, be consistent and reliably responsive per the terms of your scope of service.